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MAR-21-2005 09:45 FROM: T0:14�52578857 P.1 <br /> j <br /> PERMIT APP �LICATION <br /> GlTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98207 <br /> 425-257-8810— FAX425-257-8857—www•everettwa.org 2 ,��.� � <br /> � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PA7 - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT#' <br /> I (n f� V��-P�-e f'� da �6��{c�o� 6 � � �O S'v3 ��� <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. _ <br /> OWNER ADDRESS CITY2IP PHONE `r,. <br /> �nv�X �(c�hl�y I� ( l �t�.(-c I'�f �c.�e{f-�s �1'G2�1 zlo�-S�'Q/3 <br /> CO.yTA�T FOR PERMIT ���Q�NE� <br /> TENANTNAME � I j <br /> �- 'v"�v�` � <br /> CONTRACTOR ADORE55 CIN21P PHONE � � <br /> �rl � � ��� ��a� !�-c. ��� �/y5' �-�l?�U <br /> CONW�f'F�1 H����`I I �C.LL7 <br /> USE OF BUILDING MEAT SOURCE CON'lRACT PRICE OF WORK <br /> (�A—/I _E�ectric �as_Other � �� <br /> J ��L <br /> WORKDESCRIPTION 4� ,�(� 1 ., 7��'`/,.,.,' Sl� <br /> g� �„ q �' r�.rzc v �..��ti � <br /> PLUMBING MECHANICAL <br /> NO. <br /> iYPE OF FIXTl1RE GR ITEM NO. TYPE OF FUCTU9E OR ITEM <br /> A/C—alr handling units <br /> Toilet forced air systems <br /> _ Bathtub — Gas piping <br /> Lavalory(wash basin) � y�a�ar he�ter <br />, _ Showar Gas fveylace <br /> Kitchen sink 8 disposal — Gas range <br /> Dishwasher — Ctothes dryor <br /> _ Clothes washor Range huod <br /> Laundry tray — Exhaust fan <br /> _ Sink(servicelbadmopletc.) — Heat pump <br /> Beckflow preventer Unil huater <br /> _ Unnal — (�olier <br /> _ Drinking Fountain — Re��9eratlon <br /> Floor drain Woodstove <br /> I = Grease trap - Other <br /> Roof drains <br /> Olher <br /> ICIiY OF EVERETT LOCAL SALES TAX CODE I i 7105 <br /> I here6y cerili�y that I have read and ettamined this applicalion and know the same to be true and cortecl. All provisions of laws and � <br /> ordinaces 9overning this type of work will be complied wilh whether specified herein or nol.The granting of a pe!mit does not presume <br /> to give au�honry to vlolate or cancel the provislon of any other stfOte erformlthe work,fon h c�h a plicaU nri hmada a dal comply wilh the <br /> � constmclion.Thal I am aulhonzed 6y lhe owner of this property P <br /> Sla�e Co ractors La �0.27 RCW and 296.20G WAC. 3 /�' <br /> (i121�� i O(' <br /> Sigr��ure f wneq ontractor Aul e Agent ate <br /> ��� <br />